Sinusitis

What is sinusitis?

Sinusitis is an infection of the lining of the sinuses near the nose. These infections most often happen after a cold or after an allergy flare-up. There are 4 types:

• Acute. Symptoms last less than 4 weeks and get better with the correct care.
• Subacute. Does not get better with treatment at first. Symptoms last 4 to 12 weeks.
• Chronic. Happens with repeated or poorly treated acute infections. Symptoms last 12 weeks or longer.
• Recurrent. If you have 3 or more episodes of acute sinusitis in a year, it’s called recurrent.

The sinuses are air-filled pockets (cavities) near the nose passage. The sinuses make mucus. This fluid cleans the bacteria and other particles out of the air you breathe. 

What causes sinusitis?

A sinus infection can happen after a cold. The cold inflames the nasal passages. This can block the opening of the sinuses and lead to infection. Allergies can also cause the nasal tissue to swell and make more mucus and cause sinusitis.

Other conditions that can lead to sinusitis include:

• Abnormalities in the structure of the nose
• Enlarged adenoids
• Diving and swimming
• Tooth infections
• Nose injury
• Foreign objects that are stuck in the nose
• Secondhand smoke

If mucus drainage is blocked, bacteria may start to grow. This leads to a sinus infection, or sinusitis. The most common viruses and bacteria that cause sinusitis also cause the flu or certain kinds of pneumonia.

What are the symptoms of sinusitis?

The symptoms of sinusitis may depend on your age. These are the most common symptoms:

Younger children

• Runny nose that lasts longer than 7 to 10 days. The discharge is often thick green or yellow, but can also be clear.
• Cough at night
• Occasional daytime cough
• Swelling around the eyes

Older children and adults

• Runny nose or cold symptoms that last longer than 7 to 10 days
• Complaints of drip in the throat from the nose
• Headaches
• Facial pain
• Bad breath
• Cough
• Fever
• Sore throat
• Swelling around the eyes, worse in the morning

The symptoms of sinusitis may look like other conditions or health problems. Always talk with your healthcare provider for a diagnosis.

How is sinusitis diagnosed?

Your healthcare provider can often diagnose sinusitis based on your symptoms and a physical exam. Sometimes other tests are done. These may include:

• Cultures from the nose
• Sinus X-rays
• Sinus CT scan. This imaging test uses X-rays and computer technology to make images of the body.
• Blood tests

How is sinusitis treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment of sinusitis may include:

• Pain relievers
• Nose drops
• Antibiotics for severe symptoms such as fever, face pain or tenderness, or swelling around the eyes  
• Surgery, if other treatments have failed

You may be referred to an allergist or immunologist, especially for chronic or recurrent sinusitis. People who have had sinus surgery, but still have sinusitis, may also be referred.

Decongestants and antihistamines do not seem to help the symptoms of sinusitis.

When should I see a healthcare provider?

Call if any of these occur:

• Vision changes
• Severe or intense facial pain or pressure
• High fever
• Neck stiffness
• Shortness of breath
• Swelling or redness around one or both eyes
• Trouble thinking

These symptoms may point to a serious condition.

Key points about sinusitis

• Sinusitis is inflammation of the lining of sinuses in the face. It mainly causes pain and too much mucus production.
• It may follow a cold or allergies.
• Inflammation caused by a virus may go away in about 10 days and won’t need antibiotics.
• Inflammation caused by bacteria needs antibiotics.
• Treatment aims to ease the pain and discomfort, and reduce inflammation and mucus production.
• Take all antibiotics as prescribed and finish the prescription.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.